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Management of Resectable and Borderline Resectable Disease: Radiation Oncology

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Pancreatic Cancer: A Multidisciplinary Approach

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Abstract

Surgical resection is the mainstay of curative treatment for pancreatic cancer. However, relapse rates with surgery alone are high. As systemic therapy improves, patients are living longer without metastatic disease. These improvements in distant control have increased the importance of optimizing local control. Historically, radiotherapy has been given in the postoperative setting to decrease local relapse after surgery. The indications and sequencing of radiotherapy are shifting, with increasing interest in a preoperative approach. Advances in radiotherapy have also made it possible to deliver higher doses to specific volumes. This may help expand the role of radiotherapy in the treatment of locally advanced and/or inoperative pancreatic cancer. Advances in target delineation, motion management, and image guidance have greatly improved the therapeutic ratio. More conformal radiation modalities such as intensity-modulated radiation therapy, stereotactic body radiation therapy, and particle therapy may offer further dose optimization to the tumor while sparing nearby organs from toxicity.

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Authors and Affiliations

  1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Emma B. Holliday, Eugene J. Koay, Cullen M. Taniguchi & Albert Koong

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  1. Emma B. Holliday
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  2. Eugene J. Koay
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  3. Cullen M. Taniguchi
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  4. Albert Koong
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Correspondence to Emma B. Holliday .

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Editors and Affiliations

  1. Department of Gastroenterology Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Manoop S. Bhutani

  2. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Matthew H.G. Katz

  3. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Anirban Maitra

  4. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Joseph M. Herman

  5. Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Robert A. Wolff

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Holliday, E.B., Koay, E.J., Taniguchi, C.M., Koong, A. (2022). Management of Resectable and Borderline Resectable Disease: Radiation Oncology. In: Bhutani, M.S., Katz, M.H., Maitra, A., Herman, J.M., Wolff, R.A. (eds) Pancreatic Cancer: A Multidisciplinary Approach. Springer, Cham. https://doi.org/10.1007/978-3-031-05724-3_13

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